onlineinsurance10

INSURANCE - ONLINE

Lesson 10 - Miscellaneous Insurance - II

Introduction of the Host
Mr.Harikumar is a freelance journalist with rich experience gained from working with leading periodicals and dotcoms. His association with leading financial portals has contributed greatly to his ability to deal with classroom sessions in the financial sector, especially investments. Currently, he is a columnist with some of the well known publishing companies. Some of his published works on mutual funds and insurance have got wide acclaim.

MISCELLANEOUS INSURANCE - II

OVERSEAS MEDICLAIM POLICY

This is one of the popular miscellaneous insurance policies. This provides for medical expenses incurred for illness or diseases or injuries sustained during the travel overseas. This policy can be well utilized by students studying abroad or professionals staying in a foreign country for specific assignments, etc. The period of cover is the time of travel subject to a maximum of 180 days. The policy would cover persons in the age group between 6 months and seventy years. Persons beyond the age of 70 will be considered by paying additional premium.

Persons of age beyond 60 years travelling to countries other than U.S.A and Canada and those beyond 40 years travelling to U.S.A and Canada should submit the following documents, while submitting the proposal forms.

a. Report on sugar test certified by a Cardiologist
b. ECG report

If the above documents are not submitted, the amount of claim shall be subject to a specified limit.

Under this plan, there are various claim limits according to the countries of travel. The maximum benefits available are for students and employees staying abroad. For example, persons staying in the U.S.A for study and employment will get a benefit up to $1,50,000 for medical expenses during their stay there.

Those who frequent to foreign countries for official assignments and business has been privileged customers under this policy. For them there is a special policy designed, called Corporate Frequent Travellers Policy.

F.A.Q

1. Are those accompanying the insured covered under the policy?
Yes, even children and spouse accompanying the insured are covered under this
plan

2. Is the plan available for foreign nationals visiting India?
Yes. The scope is extended to them too.

3. What are the common exclusions?
a. Treatment of illness already known.
b. Self inflicted injury- eg: suicide attempt.
c. Injury sustained while taking part in Naval, Military and Air Force operations.
d. Treatments arising from professional or adventurous sports events

MONEY IN TRANSIT INSURANCE
It is common that many a concern carry money through their messengers from one place to another. It is also common to forget about the risk involved in transit. In such situations, this type of insurance comes in handy. Here too, an advance premium is charged assuming an estimated amount to be carried. The premium, at length, is adjusted against the actual amount of loss. As soon as the insured comes to know of the loss, he has the liability to make a written complaint to the police and get it registered. A copy of the registered complaint should be sent to the insurer along with the FIR. Also, the insured is required to substantiate his claim by proper titles of ownership. The scope of the policy is also extended to cover the money while kept in safe custody, in case of house breaking, robbery or burglary.

WORKMEN'S COMPENSATION INSURANCE

Workmen Compensation Insurance is meant to cover the employers for pecuniary liability towards the employees in case of a work related injury during the course of employment. In other words, this is an insurance taken by the employer to mitigate the effect in cases where Workmen's Compensation Act is applied and the amount is liable to be paid to the employees. Willingly or not, all employees must take policy under Workmen's Compensation Act and can make claim arising out of injuries in harness.

The insurer will not pay for injury. Treatments unrelated to the workers' compensation injury. The insurer may refuse to pay by bills if the doctor has not sent all information that explains the services provided. You can assist the process making sure that your doctor is regularly sending all bills and other medical information to your insurer.

However the following are some of the exceptions where no compensation would be payable by the insurer.

1. For an injury for the first three days of disablement unless such disablement lasts for a period of 28 days or more

2. An injury which does not result either in permanent or partial disablement for a period not less than 3 days.

3. An injury sustained due to negligence or disobedience during the course of work when specific instructions have been given for the purpose of securing safety for the employees.

The employees themselves can choose the mode of claim. Either he can hire his own attorney and proceed under Common Law or choose to seek claim under Workmen's Compensation Act. But one is not allowed to file claim with both (Court and Commissioner for Workmen's Compensation) The policy is available under two tables namely Table A and Table B. Under Table A Policy, the benefits could be extended for payment of medical, surgical and hospital expenses including the cost of transport to the medical provider.

Premium
Premium is payable according to the categories of employees and the amount of wages, salaries and other earnings during employment. As a rule, provisional premiums are charged without respect to the earnings and subsequently adjusted towards the end of the period, on the basis of the actual earnings of the employees. It is to be specially noted that at the end of the insurance period, the employees necessarily needs to furnish a statement of actual payment of wages or salaries.

Preferably the employees may resort to the following while on work.
a) Report any work related injury to the concerned Supervisor on the same day of
injury.
b) Fill in and sign the report on the incident
c) Seek medical assistance at one of the authorized or certified clinics, if any.

Some injuries are permanent. If you have a permanent injury, you might receive Permanent Partial Disability (PPD) benefits.

Claim
The following are the documentation required while seeking an insurance claim under Workmen's Compensation Insurance.
1. Fill up and sign the Claim form
2. Medical certificate in respect of injury sustained and leave certificate
3. A Memorandum of Agreement as per Workmen's Compensation Act, in duplicate in case of permanent disablement
4. In case of fatal claim, a copy of the Post Mortem Report should be obtained.

In usual cases, no major problems crop up for payment of claim. If your claim is denied, you will receive a Notice of Denial. If one disagrees with the amount of claim offered by the insurance company, one could approach the department of workmen's compensation, and subsequently to the Department of Labour, where the specialists would come to the rescue of workers.

This insurance is like Provident Fund. If you wish or not, you are covered. And this stands in good stead when in need, at a later date.

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